Enteral nutrition and the small intestine.

Jenkins, A. P.; Thompson, R. P. H.

doi:10.1136/gut.35.12.1765

Cited by 19 publications

(12 citation statements)

References 94 publications

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“…Despite the clinical necessity for TPN, it is associated with both infusion-related and metabolic complications [1]. In particular, the lack of enteral stimulation alters small intestinal mucosal architecture, increases the risk of bacterial translocation and septicemia and delays the progression to full enteral support [1,4,7,8]. Herein, we have established a piglet TPN model in wich the effect of various therapies to promote gut function during TPN can be assessed.…”

Section: Discussionmentioning

confidence: 99%

“…Administration of TPN and, thus, the absence of enteral stimulation has been reported to compromise mucosal mass and architecture and/or enzyme function in human adults [3] and infants [4], adult rats [5] and neonatal piglets [6]. To promote GI function, enteral administration of small volumes of formula or breast milk to LBW infants on TPN has been investigated [4,7,8]. Infants receiving enteral stimulation had earlier tolerance of full enteral intake, shorter duration of TPN and more rapid rates of body weight gain and maturation of GI motility [1].…”

Section: Introductionmentioning

confidence: 99%

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Delivery of Total Parenteral Nutrition (TPN) via Umbilical Catheterization: Development of a Piglet Model to Investigate Therapies to Improve Gastrointestinal Structure and Enzyme Activity during TPN

Park¹,

Monaco²,

Donovan³

1998

Neonatology

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Nutritional support of preterm infants by total parenteral nutrition (TPN) is common; however, TPN compromises intestinal structure and enzyme activity. Our goal was to develop a piglet model to assess the effect of limited enteral stimulation with formula and insulin-like growth factor-I (IGF-I) on intestinal morphology and enzyme activity. A nutritionally complete TPN solution was infused for 7 days and piglets were gavaged twice daily with 4 ml sterile water, formula, or formula containing 1,000 µg/l IGF-I. Litter mate piglets fed formula served as orally fed controls. On day 7, body weights and plasma hormone profiles of TPN and orally fed piglets were similar. However, intestinal weight, jejunal and ileal villus height and surface area, and mucosal lactase and sucrase activity of TPN piglets was reduced by ∼50%. No effect of limited enteral stimulation or IGF-I was observed likely due to the small volume of formula administered enterally, which resulted in a low dose of IGF-I (4.3 µg IGF-I/kg/day).

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Delivery of Total Parenteral Nutrition (TPN) via Umbilical Catheterization: Development of a Piglet Model to Investigate Therapies to Improve Gastrointestinal Structure and Enzyme Activity during TPN

Park¹,

Monaco²,

Donovan³

1998

Neonatology

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“…However, the mechanisms by which nutrients influence growth and function of the gastrointestinal tract are poorly understood and likely to be multifactorial 5. Some of the trophic effects of fibres may be due to the formation of short chain fatty acids (SCFAs) by bacterial fermentation of the fibre polysaccharides in the caecum and colon 7-9.…”

mentioning

confidence: 99%

Diabetic intestinal growth adaptation and glucagon-like peptide 2 in the rat: effects of dietary fibre

Thulesen

Hartmann

Nielsen

et al. 1999

Gut

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Background/Aims-Dietary fibre influence growth and function of the upper gastrointestinal tract. This study investigates the importance of dietary fibre in intestinal growth in experimental diabetes, and correlates intestinal growth with plasma levels of the intestinotrophic factor, glucagon-like peptide 2 (GLP-2). Methods-Male Wistar rats were randomised to the following groups: two streptozotocin-diabetic and two control groups fed either a fibre-containing or a fibre-free diet for three weeks. Intestinal weight, length, and morphometric data (villus height, villus area, crypt depth) were measured. Blood samples were obtained after two weeks for measurement of GLP-2 and enteroglucagon (glicentin, oxyntomodulin). Results-The mean daily consumption of food in the two diabetic groups was 40% higher than in controls. In diabetic rats fed fibre, the increase in intestinal weight from day 0 to 20 was sixfold greater than that of the controls and small intestine weight per cm length was increased by 50%. In the diabetic rats fed a fibre-free diet, intestinal growth was 30% less than in diabetic rats fed fibre, and intestinal weight increased only threefold compared with controls. Morphometric data showed that the intestinal increase in diabetic rats fed fibre was due primarily to growth of the mucosal layer. Villus height and crypt depth increased 60% and 40% respectively, but by only 20% in fibre-free diabetic rats. The plasma levels of GLP-2 parallelled diabetic intestinal growth, whereas plasma levels of enteroglucagon increased regardless of the extent of intestinal growth. Conclusions-Intestinal growth in experimental diabetes is strongly influenced by the presence of dietary fibre. The eVect may be mediated by GLP-2. (Gut 1999;45:672-678)

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“…Enteral nutrition in the small intestine has been reviewed (58). Glutamine, the most abundant amino acid in the plasma, is released from skeletal muscle and used as the preferred fuel for enterocytes.…”

Section: Intestinal Growth: Mucosal Proliferation and Differentiationmentioning

confidence: 99%

Small Bowel Review - Part I

Thomson

Jarocka-Cyrta

Faria

et al. 1997

Canadian Journal of Gastroenterology

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Enteral nutrition and the small intestine.

Cited by 19 publications

References 94 publications

Delivery of Total Parenteral Nutrition (TPN) via Umbilical Catheterization: Development of a Piglet Model to Investigate Therapies to Improve Gastrointestinal Structure and Enzyme Activity during TPN

Delivery of Total Parenteral Nutrition (TPN) via Umbilical Catheterization: Development of a Piglet Model to Investigate Therapies to Improve Gastrointestinal Structure and Enzyme Activity during TPN

Diabetic intestinal growth adaptation and glucagon-like peptide 2 in the rat: effects of dietary fibre

Small Bowel Review - Part I

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